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Being with pain

For the past five days, I have been dealing with a severe bout of hemorrhoids, something the likes I've never had before. I wrote Jundo, mentioning that I was unable to sit, and explained why; I told him I've been trying lying-down meditation instead.

He replied:

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Ah, I see (really. I mean, between my desk bound work and the Zafu, I really, really see!) Well, around here, you should know exactly what to do in that case: When having hemorrhoids, just have hemarrhoids. Just sit, recline or stand on your head with your hemorrhoids. When they are a pain in the butt, let them be a pain in the butt. Be one with your hemorroids. Observe the annoyance. The experience is just what it is, nothing to take away from it or add to it .... even as you apply the Preparation H. Just be mindful as you apply the Preparation H.

And if you think I am trying to make a joke about the hole thing, I certainly am not. I am serious. One of the best times to practice is when you have some health issue come up. So, please just sit with it, stand with it or whatever.

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So this evening, lying down and trying to meditate, I realized something (ok, I wasn't letting body and mind drop away, but thinking): for five days, I've been doing everything possible to avoid the pain, to distract myself from the pain, rather than trying to be with it. I have observed the pain, but mostly to try and get it out of my mind. This is normal, of course, because it hurts. But if I try to be with the pain, to experience its angles, its power, its intensity and the reactions it insights, the pain becomes different. I've tried this before - I have a neurological condition that gives me chronic pain, and, even though medication helps, it doesn't help all the time. I try, when in pain, to be with the pain and go through it; it works sometimes, but most times it doesn't.

But what really came to me this evening was the awareness of how we (or at least I) do the same thing about all kinds of pain. Not just the physical, but the mental. We try and distract ourselves so we don't have to face it, to feel it, and we construct ideas and realities to wall ourselves off from it, rather than be one with it. Sure, I'm not breaking any new ground; all the Buddhists talk about this stuff, but realizing it personally, concretely, is interesting and enlightening (in a minor way, of course).

Anyone who has a chronic illness, especially if it involves pain, probably knows how you can become that illness, or at least become intensely involved with it. It can take control of you, because it is so present, so invasive. Perhaps we all have chronic illness - the one called life - and we are controlled by that illness to the point that we can't see outside of it. Perhaps a little pain can help, can be a prod that will make us see this reality just a bit differently.

Now that your are focusing on being mindful of the pain do you notice any change in the discomfort or intensity of the sensations?

I have found that during times of illness or injury that if I allow myself to be fully present with the pain (especially in Zazen) that it loses some of its edge. Perhaps the only change is the perspective on the pain, as we lesson our resistance to it we seem to suffer less.

Just my thoughts on the issue, I'd be interested in hearing if your experiance is similar.

I find that the pain sensation "follows" my breathing in a way. The pain is different on the in-breath than the out-breath, different on the short breath than the long breath, etc. Once I notice a pattern (eg it's most intense at the beginning of an exhalation), I initially respond by tensing up in anticipation of pain. Gradually, I manage to relax into the sensation instead, acceptance instead of resentment or evasion.

Well, there are two things. First, as paige says, there can be a difference in the pain on the in-breath and out-breath, but I think that depends on where the pain is, and whether it is actually affected by the breath. But, yes, I do find that if I really move into the pain, mentally, it does change. As you say, it can lose some of its edge, but even more so, it becomes less subjective: I find that instead of "my" pain, it becomes just pain. This is a big difference, because it's like accepting that pain "is" rather than it being there to annoy Me.

being with pain

Dear Kirk: I am wondering how you are doing. This is such a good topic.
I've had various levels of pain from different types of things for many years. While not pleasant, it also does not have to be unpleasant, and certainly does not have to be 'suffering.'
All the suggestions offered sounded very good. I have come to view my various pains as a pack of dogs--who follow me from room to room.
Sometimes they growl at each other or nip at me. Some of them are more feisty than others at different times. Sometimes they all curl up and each just minds his own business, one licking it's paws, one scratching, one twitching in it's dreams. I view this entourage of pain as my companions, not that I would have chosen them, but they have come to me like stray animals I now take care of. Every now and then my knees dislocate--now there is a pain in a whole new category--and not part of this pack of chronic critters. I'm able to breathe (barely) and I relax into, around, through and it is wonderful when 'badumpf' the knee joint moves back where it belongs. Thank goodness I don't have that level of pain on a constant basis. It sure would take some work to fully accept it. And I am thankful that I get to practice dealing with pain in the doses I get it--with this human body, who knows what lies ahead? Joys and sorrows, pleasures and pains!

I'm having a similar struggle with pain as I have CFS/ME at the moment and get a range of joint pains and headaches as well as just general fatigue.

Having lost my job due to illness, selling our house/car to down size amongst other things I am working hard to accept the reality of the situation as it is. Just sitting has helped me to become more accepting of the changes that are happening in and around me.

Don't get me wrong I have moments of frustration and anger but I do find that little by little the issues and pains are not things that I need to fight against but accept that this is how things are just now.

I have also been all confused about this thing of whether zazen is zazen if you're not in half/full lotus, proper posture required etc.. Sitting 3x daily in sieza has left me annoyed that my body is now complaining ( I find this a very stable position) but I think I'm now going to have to lie down for zazen sometimes, and to me it will still be zazen. The peace and balance I get from zazen is far more important to me than how I am positioned so I accept that at this moment kneeling is not beneficial to me but 'sitting' is.

Do you find that zazen helps with your neurological condition? It certainly has short term benefits with my headaches and concentration, may be these will be come long term.

First, I myself do not suffer with physical pain. So, you know, this is one of the few topics on which I hesitate to offer an opinion (and this from a man who has an opinion on everything and is supposed to be in charge around here). I yield to the Wisdom and experience of the several members of this community who do have various physical conditions and are sitting with them. Learn from them.

That being said, I see no problem with sitting as you need to sit (and that means "just sitting" by lying down or standing on your head or any other way) if that is what your body requires. Buddha did it too when ill ....

This will also be the one time ever (ha ha) when I recommend a book on meditation that is not strictly about "Shikantaza" just sitting. That is because the book is (I believe) widely considered the best book on the subject, written from a non-religious point of view by a professor and doctor who is one of the great experts on mediation and pain, widely well received in the medical community. The book has practical exercises. You can read what people think of it by scrolling down the following page and reading reviews. You can also get a copy there:

Meditation does help me a lot. There are many reasons for this, including the way the meditative state enhances some neurotransmitters. (I could get more technical if you want; I'm that kind of person, I read up on these things.)

As for the Kabat-Zinn book, it's what I've recommended to people with the same condition as I have, especially for its "secular" approach to meditation. Many people are afraid of meditating if they're told it's Buddhist (or whatever). It is a big book, and it can be, at times, a bit of a dense read, but I think it's worth getting through. While his science is a bit outdated - if he updated the book or wrote it now, he'd have a host or research to cite - it still stands as valid.

Kirk, I'd be quite happy if you could explain it and get a bit technical as I'm not joking about it taking some conseiderable time for me to get through the book(It was re-issued in 2001 and this is the most recent re-print so it may be updated). If you feel it's inapproprite for on here feel free to PM me with it.

Meditation has many effects on the brain, and on the chemicals that float around in it. One of them is gamma-aminobutyric acid (GABA), which is the main inhibitory neurotransmitter. Inhibitory means that it blocks nerve impulses. Pain and other problems such as epilepsy, or the symptoms I have, can be blocked by GABA, or at least reduced. So when you meditate, the complex chain of chemicals works to increase the amount of GABA in the brain. This then has a whole chain of effects on other neurotransmitters, and on the rest of your body.

For a number of reasons, you can't just add GABA to your body. (The main reason being what's called the blood-brain barrier; many meds cannot cross into the brain.) There are, however, some meds that attempt to function like GABA, or increase GABA in different ways, and these are used for pain, anxiety, and as anti-epileptics. For example, valium is a GABA agonist (meaning that it increases GABA). Its original use was as an anti-epileptic, but because of GABA's many effects, it is very efficient as an anti-anxiety med, muscle relaxer, etc. Some GABA agonists are used for migraines (gabapentin, among others), fibromyalgia (lyrica was recently the first med approved for FM), chronic pain, etc.

There are lots of other chemicals involved, but GABA is one of the most important. Increasing it acts as a damper on over-excited neurons. Other chemicals may make you feel better overall (endorphins) or blunt pain (dopanime).

I hope this helps. If you're _really_ curious, two books by James Austin are heavy reading but interesting: Zen and the Brain and Zen-Brain Reflections.

Best,

Kirk

PS: I had heard of CFS, but not ME. It seems to generate Google hits mostly in the UK. Does it have a different name elsewhere? Is it the same as fibromyalgia?

I have also been all confused about this thing of whether zazen is zazen if you're not in half/full lotus, proper posture required

Recently in my practice I am discovering how important posture is. If I'm sitting at the computer and start to hunch and lean into the screen, this effects my whole ability to be clear. Also balance is becoming clear to me. I had a nap in the afternoon, which effected my nightly sleep. When 1:00am came around I wasn't tired at all (maybe it was the cup of coffee I had too). I stayed up until 3:00 sitting the couch smoking cigarettes and writing as song based on a Street Car Named Desire. When I went to bed, I kept arranging the song in my head. This morning I'm definitely feeling it. Well, I have to go teach class.

The Mind Body Institute is doing some remarkable work on this meditation connection with the brain. The recent conference with the Dalai Lama at Emory brought together a number of amazing shrinks who were quite accessible with some complex theories about the effects of meditation on the brain. You can some of the work on their website. I am plowing through some Alan Wallace who has quite a lot to say on this topic.
Gassho,
David aka PapaDoc

I have the opposite problem. Because of a neck injury sustained in the war, and subsequant surgeries and the addition of titanium to my skeletal makeup, I can only sit ramrod straight. My meditation suffers because of pain, sometimes, but my meditative posture looks fantastic!
I can't recline or anything though and meditate because my breathing becomes a bit unnatural due to the positioning of my head in thoe postures.
Odd, eh?